Pengaruh penerapan standar terapi dan regulasi terhadap pola peresepan di Rumah Sakit Pupuk Kaltim = The influence of standard treatment and regulation to prescribing in Pupuk Kaltim Hospital

Background: Pupuk Kaltim Hospital is a private hospital belonging to Pupuk Kaltim Company (BUMN), which is still supporting the resources for its operation. The National policy of regional otonomy effective from January 15t 2001 and privatisation of PT Pupuk Kaltim affect the prospect of Pupuk Kaltim Hospital (Foundation). The prescription pattern in Pupuk Kaltim Hospital is still irrational which impacts on the increasing total cost for medicine, and patients pay more than they suppose to. Therefore some control system such as standard treatment and regulation should be developed. Objectives: This study was aimed at assessing how the Therapeutic Standard and regulation could improve the prescription pattern. The attributes evaluated include: antibiotic prescription, generic drugs prescribing, total items of drugs in one prescription and total cost of every prescription. Method: Quasi experimental-method was applied in the study with two prescription group as its unit analysis, i.e: Diagnosis of Acute Upper Respiratory Infection and Acute simple Gastroenteritis without dehidration (Diare) as an intervention group. Acute gastritis and Asthmatic patients as control group. Results: Result showed that there was a significant improvement in almost all prescription after intervention. The difference between intervention and control groups in terms of the number of drugs prescribed for upper respiratory tract infection decreased from 3,8 to 3,3 and for acute Gastro-enteritis from 3,62 to 3,55 (pE 0,01). There were different patterns of generic prescription in acute gastroenteritis group after application of standard treatment (X2= 5,158, p=0,02)in the intervention group compared with control group (upper respiratory tract infection and asthma, X2 4,222, p= 0,01)in the generic drugs patterns, and the available single prescription (p< 0,01). This study showed that standard treatment significantly improved prescribing pattern if it is followed by regular monitoring and structured feedback to prescribers. Keywords: rational prescription, standard treatment, feed-back monitoring result